This article summarizes the provisions of the final 2026 HHS Notice of Benefit Payment Parameters related to the individual ...

The difficulty that stakeholders face in comparing contracts with different structures could be solved by a standardized pricing methodology across payers.

Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage ...

President Trump reinstated an expanded version of the so-called “Mexico City policy,” which prevents organizations that ...

While evidence-based decisions are essential, they must be paired with effective public messaging that builds trust and ...

Consolidation of physician practices, largely driven by health systems, has motivated policy efforts to move care toward lower-price, non–health system settings. At the same time, however, private ...

Private equity (PE) acquisitions of health care providers are often framed as a monolithic intervention, but firms’ strategies for generating returns for investors may vary. In a ...

Thomas C. Buchmueller ([email protected]) is the Waldo O. Hildebrand Professor of Risk Management and Insurance at the Ross School of Business, University of Michigan, in Ann Arbor. Helen G.

Given the prevalence of managed care, it’s incumbent upon the industry to ensure that there is a robust supplier pool.

Oklahoma and South Carolina are among nine states that use some form of provider-based reference pricing to contain spending ...

We examine key lessons on medical-dental integration from the Program of All-Inclusive Care for the Elderly (PACE), ...